‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual causes related to a home packed of loud adolescent children, but because it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons avoid discussing this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|